State health expert: Opioid addiction a public emergency

By Jake Zuckerman

As part of Virginia’s uphill battle against a growing heroin epidemic, the state health commissioner on Monday declared opioid addiction to be a public health emergency.

As a result of the public emergency, State Health Commissioner Dr. Marissa Levine issued a standing order to allow pharmacies to sell Naloxone – a drug used to resuscitate victims experiencing an opioid overdose – without requiring a prescription.

She said the decision comes as the addiction trend is gaining traction, and the national attitude needs to switch from seeing drugs as a crime issue to a public health issue instead.

“Today I am declaring a public health emergency for Virginia as a result of the opioid addiction epidemic,” Levine said on Monday. “This declaration is an effort to raise continued awareness among all Virginians as a worsening problem and emphasizes that we must treat it as a public health issue as we have done for other health emergencies. Our law enforcement partners have repeatedly claimed that we cannot arrest our way out of this problem. I’ve heard them loud and clear, and I agree.”

Naloxone will be sold for roughly $120 at pharmacies as a nasal spray, and an autoinjector will also be available at a higher price according to Executive Director of the Virginia Board of Pharmacy Caroline Juran. She said some third-party insurers will cover all or part of the cost of the drug.

Making her case, Levine offered sobering statistics on the state of the battle against heroin and other opioids tearing through Virginia. She said an average of three Virginians die of a drug overdose everyday, and more than 24 victims of overdoses require emergency room treatment.

She added the number of emergency room visits over the first nine months of the year for heroin overdoses is up 89 percent from the same time period in 2015. Likewise, fatal overdoses for 2016 are expected to be 77 percent higher than the same statistic from 2015.

Along with a heroin problem, Levine said there has been a surge in synthetic opioids appearing throughout the state such as fentanyl and carfentanil, an elephant tranquilizer.

“The Department of Forensic Science just this month identified presence of carfentanil in Virginia,” Levine said. “This synthetic opioid is 10,000 times more potent than morphene and 100 times more potent than fentanyl. Given its presence in Virginia it could significantly increase death rate trends we’re seeing from opioid overdose.”

Speaking on the logistics of the newly available Naloxone, Juran said while there have been issues acquiring Naloxone in the past, the standing order from the director of health should enable easy access to the drug. She specified the standing order will serve as a de facto prescription for any individual seeking to buy Naloxone.

“The statewide standing order will authorize any pharmacy to dispense Naloxone to any interested person who wants to have the drug on hand for any person they believe is experiencing or is about to experience an opioid overdose,” Juran said.

She continued saying along with recreational drug users, many of those who take painkillers for chronic pain require Naloxone in the event of an accidental overdose.

Dr. Jack Barber, interim commissioner of the Virginia department of behavioral health and developmental sciences, said much of the toll the heroin epidemic has taken on the communities it hit is not accounted for in the usual statistics.

“There is a toll each community is paying for those that are addicted but they may not be dying yet,” he said. “There’s a loss of productivity, there are disruptions in family relationships, there are other health risks associated with it. So the problem is that death is just the tip of the iceberg of an increasing problem that’s taking us over.”

While the decision has been made, Juran said it will take time for pharmacies to be ready to begin selling Naloxone over the counter.

This decision comes less than a week after the U.S. Surgeon General Vivek Murthy released a report detailing the massive scope and impact of the drug addiction crisis in the U.S.

According to a news release from the office of Gov. Terry McAuliffe, all Virginians can combat drug addiction in their communities by knowing the signs of drug dependence, talking to their loved ones about drug dependence, properly disposing of medications, obtaining Naloxone and educating themselves on how to use it. More information on preventative measures is available through the state’s drug awareness site www.vaaware.com.